title: Analysis of efficacy and cost-effectiveness of high-dose arabinoside versus daunorubicin chemotherapy in older adult patients with acute myeloid leukemia by cytogenetic risk profile: retrospective review from China.
abstract: High-dose arabinoside (HiDAC) and daunorubicin (DNR)-based chemotherapy are the primary consolidation treatment options for older adults (50-60 years old) with acute myeloid leukemia in China. We analyzed the event-free survival (EFS) and hospital treatment charges of older adult patients with different cytogenetic risk profiles. In patients with a better/intermediate risk profile, the average total treatment cost of HiDAC was similar to that of DNR (P = 0.11). A 5-year follow-up of patients with better/intermediate cytogenetic risk profiles revealed that the median EFS of patients who received HiDAC was significantly longer than for patients who received the DNR-based regimen (27 vs. 20 months, P = 0.03). Average cost per year of life saved was 18,746.84 USD for HiDAC, compared to 32,733.37 USD for DNR. In contrast, for patients with a poor cytogenetic risk profile, the average total treatment cost for HiDAC was higher than for DNR (P < 0.005). In addition, the median EFS in the HiDAC protocol group was significantly lower than in the DNR group (11 vs. 20 months, P = 0.003). Meanwhile, in this risk group, the average cost per year of life saved was 103,237.70 USD compared to 32,277.93 USD, respectively, in the HiDAC and DNR regimens. We conclude that HiDAC is a more efficacious and cost-effective consolidation treatment regimen in the better/intermediate risk group, while the DNR-based regimen is more cost-effective in the poor risk group.
authors.affiliation: Department of Hematology, Nanfang Hospital, Southern Medical University, 1838 Guangzhou Avenue North, Guangzhou, 510515, People's Republic of China.
authors.forename: Bin-Tao
authors.initials: BT
authors.lastname: Huang
authors.affiliation: Department of Hematology, Nanfang Hospital, Southern Medical University, 1838 Guangzhou Avenue North, Guangzhou, 510515, People's Republic of China.
authors.forename: Yu
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Department of Hematology, Nanfang Hospital, Southern Medical University, 1838 Guangzhou Avenue North, Guangzhou, 510515, People's Republic of China.
authors.forename: Qing-Feng
authors.initials: QF
authors.lastname: Du
authors.affiliation: Department of Hematology, Nanfang Hospital, Southern Medical University, 1838 Guangzhou Avenue North, Guangzhou, 510515, People's Republic of China.
authors.forename: Jun
authors.initials: J
authors.lastname: Yang
authors.affiliation: Department of Surgery, School of Medicine, University of Colorado Denver, Aurora, 80045, USA.
authors.forename: Jessica
authors.initials: J
authors.lastname: Yu
authors.affiliation: Department of Medicine, The Affiliated Hospital of Guangdong Medical College, Guangdong Medical College, Zhanjiang, 524001, People's Republic of China.
authors.forename: Qing-Chun
authors.initials: QC
authors.lastname: Zeng
authors.affiliation: Department of Hematology, Nanfang Hospital, Southern Medical University, 1838 Guangzhou Avenue North, Guangzhou, 510515, People's Republic of China.
authors.forename: Na
authors.initials: N
authors.lastname: Xu
authors.affiliation: Department of Hematology, Nanfang Hospital, Southern Medical University, 1838 Guangzhou Avenue North, Guangzhou, 510515, People's Republic of China.
authors.forename: Jin-Fang
authors.initials: JF
authors.lastname: Zhang
authors.affiliation: Department of Hematology, Nanfang Hospital, Southern Medical University, 1838 Guangzhou Avenue North, Guangzhou, 510515, People's Republic of China.
authors.forename: Lu-Lu
authors.initials: LL
authors.lastname: Xu
authors.affiliation: Department of Hematology, Nanfang Hospital, Southern Medical University, 1838 Guangzhou Avenue North, Guangzhou, 510515, People's Republic of China.
authors.forename: Xu-Jing
authors.initials: XJ
authors.lastname: Luo
authors.affiliation: Department of Hematology, Nanfang Hospital, Southern Medical University, 1838 Guangzhou Avenue North, Guangzhou, 510515, People's Republic of China.
authors.forename: Yong-Qiang
authors.initials: YQ
authors.lastname: Wei
authors.affiliation: Department of Hematology, Nanfang Hospital, Southern Medical University, 1838 Guangzhou Avenue North, Guangzhou, 510515, People's Republic of China. lxl2405@126.com.
authors.forename: Xiao-Li
authors.initials: XL
authors.lastname: Liu
mesh_terms: D000903:Antibiotics, Antineoplastic / Q000627:therapeutic use*; D000964:Antimetabolites, Antineoplastic / Q000627:therapeutic use*; D003362:Cost-Benefit Analysis; D003561:Cytarabine / Q000627:therapeutic use*; D020732:Cytogenetic Analysis; D003630:Daunorubicin / Q000627:therapeutic use*; D005260:Female; D017048:Health Care Costs; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000188:drug therapy* / Q000235:genetics; D008297:Male; D008875:Middle Aged
chemical_list: D000903:Antibiotics, Antineoplastic; D000964:Antimetabolites, Antineoplastic; D003561:Cytarabine; D003630:Daunorubicin